不同剂量缬沙坦治疗合并高血压的慢性肾小球肾炎疗效研究被引量：11

不同剂量缬沙坦治疗合并高血压的慢性肾小球肾炎疗效研究

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摘要目的评价常规剂量与高剂量的缬沙坦对慢性肾小球肾炎合并高血压的肾脏保护作用。方法将2004年3月至2006年1月中南大学湘雅二医院肾内科住院的30例慢性肾小球肾炎患者随机分为常规剂量组(n=15)和高剂量组(n=15),常规剂量组口服缬沙坦160mg/d,高剂量组口服缬沙坦320mg/d,疗程6个月。观察24h尿蛋白、血压、血清肌酐、估算肾小球滤过率(GFR)及血钾的变化。结果两组患者的基线临床资料基本相似,6个月后,两组患者的血压控制差异无统计学意义,常规剂量组血清肌酐(Scr)从(141±53)μmol/L升至(186±61)μmol/L,GFR从(68±30)mL/min降至(61±32)mL/min;而高剂量组Scr[(141±62)μmol/L到(142±71)μmol/L]和GFR[(67±38)mL/min到(69±38)mL/min]在观察期间无明显改变;高剂量组蛋白尿下降更为显著(P<0.05);两组血清钾均无明显改变。结论对慢性肾小球肾炎伴高血压的患者,高剂量缬沙坦在减少蛋白尿、延缓慢性肾功能衰竭的进展方面更为有效。

作者李建飞温黎青刘伏友刘虹彭佑铭赵勤

机构地区广西医科大学第五附属医院柳州市人民医院肾内科中南大学湘雅二医院肾内科

出处《中国实用内科杂志》 CAS CSCD 北大核心 2008年第5期388-389,共2页 Chinese Journal of Practical Internal Medicine

关键词慢性肾脏病肾素血管紧张素系统血管紧张素Ⅱ受体拮抗剂 chronic kidney disease RAS ARB

分类号 R5 [医药卫生—内科学]

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参考文献8

1Remuzzi G, Perico N, Macia M, et al. The role of renin-angiotensin- aldosterone system in the progression of chronic kidney disease [J]. Kidney Int Suppl,2005,12(99) :57 -65.
2Lewis EJ. The role of angiotensin Ⅱ receptor blockers in preventing the progression of renal disease in patients with type 2 diabetes[J]. Am J Hypertens,2002,15 (10) : S123 - 128.
3Forclaz A, Mailard M, Nussberger J, et al. Angiotension Ⅱ receptor blockade:is there truly a benefit of adding an ACE inhibitor? [J]. Hypertension ,2003,41 ( 1 ) :31 - 36.
4侯凡凡,谢迪.慢性肾脏病的治疗——合理降压控制尿蛋白逆转肾小球硬化[J].中国实用内科杂志,2007,27(13):1010-1012. 被引量：29
5王玉,李晓玫.慢性肾脏病与高血压相关研究的热点问题[J].中国实用内科杂志,2007,27(10):814-818. 被引量：16
6Nakao N,Yoshimura A, Mofita H, et al. Combination treatment of angiotensin-Ⅱ receptor blocker and angiotensin-converting enzyme inhibitor in non-diabetic renal disease(COOPERATE) :a randomized controlled trial [ J ]. Lancet,2003,361 ( 9352 ) : 117 - 124.
7Weinberg AJ,Zappe DH, Ramadugu R, et al. Long-term safety of high-dose angiotensin receptor blocker therapy in hypertensive patients with chronic kidney disease [ J ]. J Hypertens Suppl, 2006, 24(1) :95 -99.
8Foga AB. Progression versus regression of chronic kidney disease [ J ]. Nephrol Dial Transplant,2006,21 ( 2 ) :280 - 284.

二级参考文献12

1Chobanian AV,Bakris GL,Black HR,et al.The seventh report of the joint national committee on prevention,detection,evaluation,and treatment of high blood pressure:the JNC 7 report[ J ].JAMA,2003,289(19):2560 -2572.
2Peterson JC,Adler S,Burkart JM,et al.Blood pressure control,proteinuria,and the progression of renal disease.The modification of diet in renal disease study[J].Ann Intern Med,1995,123(10):754 -762.
3Jafar TH,Stark PC,Schmid CH,et al.Progression of chronic kidney disease:the role of blood pressure control,proteinuria,and angiotensin-converting enzyme inhibition:a patient-level meta-analysis[ J ].Ann Intern Med,2003,139 (4):244-252.
4Bakris GL,Weir MR,Secic M,et al.Differential effects of calcium antagonist subclasses on markers of nephropathy progression[ J ].Kidney Int,2004,65 (6):1991-2002.
5Locatelli F,Vecchio LD,D'Amico M,et al.Is it the agent or the blood pressure level that matters for renal protection in chronic nephropathies?[ J].J Am Soc Nephrol,2002,13 (S3):196-201.
6Ruggenenti P,Perna A,Remuzzi G; GISEN Group Investigators.Retarding progression of chronic renal disease:the neglected issue of residual proteinuria[ J ].Kidney Int,2003,63 (6):2254 -2261.
7Forman JP,Brenner BM."Hypertension" and "microalbuminuria":the bell tolls for thee[ J ].Kidney Int,2006,69 (1):22 -28.
8Brenner BM,Cooper ME,de Zeeuw D,et al.Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy[ J].N Engl J Med,2001,345 (12):861 -869.
9Nakao N,Yoshimura A,Morita H,et al.Combination treatment of angiotensin-Ⅱ receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease(COOPERATE):a randomised controlled trial[ J ].Lancet,2003,361 (9352):117-124.
10Remuzzi A,Gagliardini E,Sangalli F,et al.ACE inhibition reduces glomerulosclerosis and regenerates glomerular tissue in a model of progressive renal disease[ J ].Kidney Int,2006,69(7):1124-1130.